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Māori health boss calls for strategy to end cigarette sales

The head of the country's largest Māori public health organisation wants the Government to develop a strategy to end tobacco sales in New Zealand.

Hāpai Te Hauora chief executive Lance Norman made the call at a briefing of the health and Māori affairs select committees on the country's Smokefree 2025 target. in reality the target means having fewer than 5 per cent of people smoking.

"Given that 5000 people die of smoking-related diseases every year, that wouldn't occur if we didn't have cigarettes sold in this country, there should be an active supply reduction strategy," Norman said after the briefing.

"Over time we should get to a point where we don't sell tobacco in this country."

Health Promotion Agency data shows 16 per cent of people aged 15 or older smoke, down from 20 per cent in 2006/07.

For Māori, the figure is 35 per cent, down from 42 per cent; for Pasifika it's 25 per cent, down from 27 per cent.

"If we don't make a stand nothing will change," Norman said. "We're going to have to make some bold moves now."

Under the current sequence of tobacco tax rises, the tax increases by 10 per cent at the start of each year from 2017-2020.

When the previous government introduced the tax increases, then associate health minister peseta Sam Lotu-liga said raising the price of tobacco was the single most powerful tool to reduce smoking.

The price of a standard pack of 20 cigarettes was expected to rise from around $20 in 2016 to $30 in 2020, bringing in an extra $425 million in tax revenue over the four years.

On a 20-pack with a recommended consumer price of $25.50 - around the average at the start of 2018 - taxes (excise and GST) amounted to $19.86, or 78 per cent of the total. In 2010, a 20s cigarette pack cost about $11.

In an article in December, former Ministry of Health deputy director-general Kathy Spencer asked whether it was ethical for the Government to collect nearly $2 billion a year in extra tax from addicted smokers, while spending only 3 per cent of the money on helping them to quit.

Norman said he welcomed the tax increases to 2020 but he was also pleased the Government was undertaking a tobacco tax review.

"Increasing taxes has a positive and a negative impact," he said. "From a positive point of view it makes it too expensive for young people to get into." The high cost of cigarettes had resulted in a drop in the number of young people who were starting to smoke.

"But people who can't give up are still buying cigarettes at higher prices." As a result some were unable to pay for basics such as healthy food and rent.

If a total ban on selling tobacco was considered too difficult for now, he suggested a logical starting platform would be to stop dairies selling tobacco.

He also wanted to see nicotine electronic e-cigarettes and vaping included in a harm minimisation strategy. The sale and supply of e-cigarettes is illegal.

For those who had social issues to deal with, "I'm empathetic that your smoke gets you through the day, sometimes in tough times," Norman said.

"Could that fix come from an e-cigarette that is way less harmful for you?" Ideally cigarettes would be more expensive than e-cigarettes. He wanted to see a conversation about the possibility of subsidising e-cigarettes, and more information provided about the alternatives to smoking.

More of the excise tax from tobacco also needed to be put back into community health initiatives, Normal said. "Most of the smoking cessation services we have now aren't culturally appropriate."

He suggested a possible approach would be for such people as midwives or budgeting advisers, who saw smokers on other matters, to be more active in trying to help them get the help they needed to quit smoking.

"Our problem is a lot of our vulnerable whanau aren't accessing services early enough, and are missing some very good health advice."